Is your smile everything you want it to be? Take a few moments to answer this short evaluation to discover if there is any areas where you would like to see esthetic improvements.

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	YES	NO
Do you dislike the color of your teeth?
Do you have spaces between your teeth that bother you?
Do you have chips or uneven edges on your teeth?
Do you feel that your teeth are too long or too short?
Do you have dark fillings that show when you smile?
Do your gums show to much when you smile?
Are your teeth crowded or crooked?
Do you have existing crowns or dental work that you consider "ugly"?
Are you self-conscious of your teeth and/or smile?
Has anyone (family member, friend, etc.) ever suggested that you should have something done with your teeth or smile?
Do you avoid smiling when you have your picture taken?
Would you like to improve your existing smile?
Do you wish you had a new smile?
What concerns do you have regarding dental treatment to improve your smile? Fear of treatment Time of treatment concerns Not understanding treatment Embarrassment

Feel free to call our office at any time to set up a complimentary consultation or second opinion or we will be in contact with you shortly to review your evaluation.